{"data":{"id":"us-ky/krs-304.47-020","jurisdiction":"us-ky","citation":"KRS 304.47-020","heading":"Fraudulent insurance acts -- Enforcement and penalties --","body":"Compensatory damages -- Concurrent jurisdiction of Attorney General --\nReporting of fraudulent acts -- Application of section.\n(1) For the purposes of this subtitle, a per son or entity commits a \"fraudulent insurance\nact\" if he or she engages in any of the following, including but not limited to\nmatters relating to workers' compensation:\n(a) Knowingly and with intent to defraud or deceive presents, causes to be\npresented, or prepares with knowledge or belief that it will be presented to an\ninsurer, Board of Claims, Special Fund, or any agent thereof:\n1. Any written or oral statement as part of, or in support of, a claim for\npayment or other benefit pursuant to an insurance policy or from a \"self-\ninsurer\" as defined by KRS Chapter 342, knowing that the statement\ncontains any false, incomplete, or misleading information concerning\nany fact or thing material to a claim;\n2. To the extent not otherwise included under subparagraph 1. of this\nparagraph, any statement that misrepresents the scope of damages,\nincluding repair costs and other expenses, associated with a property,\ncasualty, or property and casualty insurance claim, including any claim\nfor towing or storage benefits under a property, casualty, or property and\ncasualty insurance policy, except this subparagraph shall not apply to\noffers or counteroffers by legal counsel representing a plaintiff or\ndefendant in a disputed claim involving bodily injury; or\n3. Any statement as  part of, or in support of, an application for an\ninsurance policy, for renewal, reinstatement, or replacement of\ninsurance, or in support of an application to a lender for money to pay a\npremium, knowing that the statement contains any false, incomplete, or\nmisleading information concerning any fact or thing material to the\napplication;\n(b) Knowingly and willfully transacts any contract, agreement, or instrument\nwhich violates this title;\n(c) Knowingly and with intent to defraud or deceive:\n1. Receives mon ey for the purpose of purchasing insurance, and fails to\nobtain insurance;\n2. Fails to make payment or disposition of money or voucher as defined in\nKRS 304.17A -750, as required by agreement or legal obligation, that\ncomes into his or her possession while acting as a licensee under this\nchapter;\n3. Presents, causes to be presented, or  prepares with knowledge or belief\nthat it will be presented to or by an insurer, or to the commissioner, any\nstatement, knowing that the statement contains any false, incomplete, or\nmisleading information concerning any material fact or thing, as part of,\nor in support of one (1) or more of the following:\na. The rating of an insurance policy;\nb. The financial condition of an insurer;\nc. The formation, acquisition, merger, reconsolidation, dissolution, or\nwithdrawal from one (1) or more lines of insurance in all or part of\nthis Commonwealth by an insurer; or\nd. A document filed with the commissioner; or\n4. Engages in any of the following:\na. Solicitation or acceptance of new or renewal insurance risks on\nbehalf of an insolvent insurer; or\nb. Removal, conceal ment, alteration, tampering, or destruction of\nmoney, records, or any other property or assets of an insurer;\n(d) Issues or knowingly presents fake or counterfeit insurance policies,\ncertificates of insurance, insurance identification cards, insurance bind ers, or\nany other documents that purport to evidence insurance;\n(e) Makes any false or fraudulent representation as to the death or disability of a\npolicy or certificate holder in any written statement or certificate for the\npurpose of fraudulently obtaining money or benefit from an insurer;\n(f) Engages in unauthorized insurance, as set forth in KRS 304.11-030;\n(g) Violates KRS 367.628(2)(a); or\n(h) Assists, abets, solicits, or conspires with another to commit a fraudulent\ninsurance act in violation of this subtitle.\n(2) A person convicted of a violation of subsection (1) of this section shall be guilty of\na Class A misdemeanor, unless the aggregate of the claim, benefit, or money\nreferred to in subsection (1) of this section is:\n(a) Five hundred dollars ($5 00) or more but less than ten thousand dollars\n($10,000), in which case it is a Class D felony;\n(b) Ten thousand dollars ($10,000) or more but less than one million dollars\n($1,000,000), in which case it is a Class C felony; or\n(c) One million dollars ($1,000,000) or more, in which case it is a Class B felony.\n(3) A person, with the purpose to establish or maintain a criminal syndicate or to\nfacilitate any of its activities, shall be guilty of engaging in organized crime, a Class\nB felony, if he or she engages in any of the activities set forth in KRS 506.120(1).\n(4) A person convicted of a crime established in this section shall be punished by:\n(a) Imprisonment for a term:\n1. Not to exceed the period set forth in KRS 532.090 if the crime is a Class\nA misdemeanor; or\n2. Within the periods set forth in KRS 532.060 if the crime is a Class D, C,\nor B felony;\n(b) A fine, per occurrence, of:\n1. For a misdemeanor, not more than one thousand dollars ($1,000) per\nindividual nor five thousand dollars ($5,000) per corp oration or twice\nthe amount of gain received as a result of the violation, whichever is\ngreater; or\n2. For a felony, not more than ten thousand dollars ($10,000) per\nindividual nor one hundred thousand dollars ($100,000) per corporation,\nor twice the amoun t of gain received as a result of the violation;\nwhichever is greater; or\n(c) Both imprisonment and a fine, as set forth in paragraphs (a) and (b) of this\nsubsection.\n(5) (a) In addition to imprisonment, the assessment of a fine, or both, a person\nconvicted of a crime established in this section may be ordered to make\nrestitution to any victim who suffered a monetary loss due to any actions by\nthat person which resulted in the adjudication of guilt, and to the division for\nthe cost of any investigation.\n(b) The amount of restitution shall equal the monetary value of the actual loss or\ntwice the amount of gain received as a result of the violation, whichever is\ngreater.\n(6) Any person damaged as a result of a violation of any provision of this section shall\nhave a cause of action in a court of competent jurisdiction to recover compensatory\ndamages, plus all reasonable investigation and litigation expenses, including\nattorney's fees.\n(7) (a) The Attorney General shall have concurrent jurisdiction to investigate and\nprosecute violations of this section in accordance with KRS 15.235.\n(b) The Attorney General, a Commonwealth's attorney, or a county attorney shall\nrefer to the commissio ner any report, investigation, or discovery of a\nfraudulent insurance act that is received, initiated, or discovered by the\nAttorney General, Commonwealth's attorney, or county attorney unless the\nfraudulent insurance act has been previously reported to the commissioner.\n(8) (a) The provisions of this section shall also apply to any agent, unauthorized\ninsurer or its agents or representatives, or surplus lines carrier who, with\nintent, injures, defrauds, or deceives any claimant with regard to any claim.\n(b) The claimant shall have the right to recover the damages provided in\nsubsection (6) of this section.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=57396","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:59Z","sha256":"e77de7a93d505ebc591a96dcc43070e12f6f557bef97bf5ef90b0d183f941a17","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.47-010","next":"us-ky/krs-304.47-025"},"notice":"GroundRules: Original legal text. Not legal advice."}